Understanding the Influence of Applied Behavioral Analysis Therapy in the Management of Children with ASD in the US

Abstract

Introduction: Over the last few decades, autism spectrum disorder (ASD) has become increasingly common among children, teenagers, young adults, and even adults. In 2020, it had a global prevalence of 2 in 200 people according to the World Health Organization (WHO,2023) and 2 in 72 people in the United States (Centers for Disease Control and Prevention, (CDC), 2024). Autism Spectrum Disorder is a neurodevelopmental disturbance that influences how individuals interact with other people, converse, gain knowledge and act. Applied behavioral therapy (ABA) is used behavioral therapy that is evidence-based and involves helping children with autism enhance positive skills and/or behavior and discourage negative ones (Child Mind Institute, 2024). This paper seeks to understand the role of behavioral intervention programs and its impact in the management of Individuals with Autism Spectrum Disorder. Methods: A secondary data collection of scholarly articles on the impact of applied behavioral analysis on children with autism was done using the PCC framework. Out of the 1900 articles identified, 39 duplicates were removed and after screening, 1791 articles were excluded due to wrong setting, intervention, comparator, patient population. 25 articles met the inclusion criteria and were included in the review. Results: Out of the 25 articles included, each article was reviewed to measure the effectiveness of ABA intervention, which was grouped into 3 outcomes, 1) Positive outcomes 2) Negative Outcomes 3) Unchanged. A cross-sectional design was done by Saar et al., 2023 to assess the perception of ABA intervention among autistic children, their families and caregivers using about 960 posts from social media although the type of ABA was not specified. Results showed that there were more positive outcomes (32%) than negative outcomes (12%) and a considerable number were unchanged (36%). Other studies done showed similar outcomes and were also outlined. . Discussion: The use of ABA therapy has proven to be an evidence-based intervention in the management of individuals with autism. Evidence-based interventions are grouped into 2 namely direct and broad-based interventions. Early intensive behavioral intervention is a type of broad-based intervention (Hume et al., 2021). Applied behavioral analysis uses both direct and broad-based interventions. From the articles reviewed, applied behavioral analysis positively impacts children with autism. Additionally, the availability of ABA services differs by race. According to Rosales et al., 2021, Black and Latinos families who have children with autism are less likely to receive ABA services early and more likely to stay longer on the waitlist before their children can receive care. However, once they receive care, most of these families are satisfied with the services they receive and are likely to recommend it to other families who have children with ASD. When compared with other articles reviewed in this study, ABA services rank high in terms of productivity and long-term benefits. Conclusion: Autism spectrum disorder and its management is a topic of public health importance, and several peer-reviewed articles, journals and grey literature serve as a helpful tool in understanding the importance of intervention strategies such as applied behavioral analysis in the management of individuals with ASD. The type of ABA service was not specified in most of the papers making it complex to analyze the effectiveness of a certain type of ABA compared to another. Although several articles exist on autism and ABA, many of them have small sample sizes therefore results gotten cannot be generalized. More studies will need to be conducted across different races, population, and geographical location to fully grasp the effectiveness of ABA services.